Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Distinct pathways of disease progression with dual checkpoint blockade versus immunotargeted therapy in metastatic renal cell carcinoma","authors":"Ilya Tsimafeyeu ,&nbsp;Fuad Guliyev ,&nbsp;Bakytzhan Ongarbayev ,&nbsp;Gunel Musaeva ,&nbsp;Ramil Abdrakhmanov ,&nbsp;Vyacheslav Chubenko ,&nbsp;Olga Baklanova ,&nbsp;Ruslan Zukov ,&nbsp;Vladislav Petkau ,&nbsp;Dilyara Kaidarova","doi":"10.1016/j.urolonc.2025.110989","DOIUrl":"10.1016/j.urolonc.2025.110989","url":null,"abstract":"<div><h3>Background</h3><div>Patterns of progression under immuno-oncology regimens in metastatic renal cell carcinoma (mRCC) remain poorly described. This study characterizes site-specific disease progression in patients receiving first-line dual immunotherapy or immunotargeted therapy.</div></div><div><h3>Methods</h3><div>This retrospective, observational cohort study included patients with clear-cell metastatic renal cell carcinoma treated between 2018 and 2024 with standard-dose regimens of nivolumab-ipilimumab (IO-IO) or pembrolizumab-axitinib and avelumab-axitinib combinations (IO-axitinib). The primary endpoint was the occurrence of new metastatic lesions at progression. Secondary endpoints included progression by &gt;20% increase in target lesion size.</div></div><div><h3>Results</h3><div>Of 334 patients identified, 233 were evaluable for analysis. Radiographic progression occurred in 86.3% of IO-IO and 60% of IO-axitinib. Development of new metastatic lesions was more frequent with Nivo-Ipi (39.3% vs. 22.2%), most commonly involving the lungs and bones. In contrast, IO-axitinib combinations showed a greater propensity for progression through enlargement of pre-existing lesions (77.8% vs. 60.7%), accompanied by the emergence of new adrenal gland metastases. Across both treatment groups, lymph nodes emerged as the most frequent new site of disease progression.</div></div><div><h3>Conclusions</h3><div>Nivo-Ipi was associated with more frequent development of new metastatic lesions, particularly in the lungs, bones, and lymph nodes, while axitinib-based combinations more often resulted in regrowth of existing disease with higher rates of adrenal involvement.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110989"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular pathology of rare histologic variants and treatment-resistant lineages of prostate cancer","authors":"Ryuta Watanabe M.D., Ph.D. ,&nbsp;Noriyoshi Miura M.D., Ph.D. ,&nbsp;Tadahiko Kikugawa M.D., Ph.D. ,&nbsp;Takashi Saika M.D., Ph.D. ,&nbsp;Michael C. Haffner M.D., Ph.D. ,&nbsp;Peter S. Nelson M.D.","doi":"10.1016/j.urolonc.2025.110987","DOIUrl":"10.1016/j.urolonc.2025.110987","url":null,"abstract":"<div><div>Rare histological variants of prostate cancer—including ductal adenocarcinoma, intraductal carcinoma of the prostate (IDC-P), neuroendocrine carcinoma, basal cell/adenoid cystic carcinoma, squamous cell carcinoma, sarcomatoid carcinoma, and stromal tumors—exhibit highly diverse biological behaviors and distinct molecular features. Accurate pathological recognition is essential, as these entities frequently diverge from conventional acinar adenocarcinoma in morphology, genomic alterations, therapeutic responsiveness, and clinical outcomes. Intraductal carcinoma of the prostate (IDC-P) and ductal adenocarcinoma often display genomic instability and aggressive clinical behavior, including enrichment for homologous recombination repair (HRR) defects and hypoxia-related pathways. Neuroendocrine subtypes, including <em>de novo</em> and treatment-related NEPC as well as double-negative prostate cancer (DNPC), are characterized by androgen receptor (AR) independence, <em>RB1/TP53</em> loss, low prostate-specific antigen (PSA) production, and poor prognosis, reflecting lineage plasticity under therapeutic pressure. Other rare tumors—such as basal cell carcinoma/adenoid cystic carcinoma, squamous cell carcinoma, and stromal tumors (STUMP and prostatic stromal sarcoma)—demonstrate unique pathological patterns and limited responsiveness to standard systemic therapies, underscoring the importance of tailored diagnostic and management strategies. This review integrates the histopathological, molecular, and emerging spatial transcriptomic insights across this spectrum of rare and treatment-resistant prostate cancer subtypes. By highlighting shared mechanisms such as genomic instability, androgen receptor (AR) pathway bypass, and microenvironmental remodeling, we outline key diagnostic considerations and evolving therapeutic implications relevant to precision oncology.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110987"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of tislelizumab plus intravesical chemotherapy in recurrent high-risk non-muscle-invasive bladder cancer: A retrospective single-center real-world study","authors":"Qing Chen PhD ,&nbsp;Rongpan Wu PhD ,&nbsp;Chen Zhang PhD ,&nbsp;Jiaxin Xie PhD ,&nbsp;Yi Wang PhD ,&nbsp;Xufeng Yu PhD ,&nbsp;Wei He PhD ,&nbsp;Maoyu Wang PhD ,&nbsp;Junjie Zhao PhD ,&nbsp;Zhensheng Zhang PhD ,&nbsp;Shuxiong Zeng PhD ,&nbsp;Chuanliang Xu PhD","doi":"10.1016/j.urolonc.2025.110988","DOIUrl":"10.1016/j.urolonc.2025.110988","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent high-risk non-muscle-invasive bladder cancer (HR-NMIBC) poses significant therapeutic challenges due to frequent recurrences. <em>Bacillus</em> Calmette-Guérin (BCG) therapy limitations including global shortages, resistance and adverse effect. Patients often decline cystectomy due to significant impact on quality of life and complications, underscoring the need for effective bladder-preserving strategies.</div></div><div><h3>Methods</h3><div>In a retrospective single-center analysis, 43 recurrent HR-NMIBC patients received intravenous tislelizumab every 3 weeks for up to 17 cycles alongside intravesical chemotherapy. Intravesical instillation agents included gemcitabine, epirubicin or mitomycin C administered per protocol. The primary endpoint was 3-month complete response rate, defined as absence of tumor confirmed by biopsy, cystoscopy, cytology and imaging. Secondary endpoints encompassed duration of response, survival metrics, and adverse events graded per CTCAE v5.0.</div></div><div><h3>Results</h3><div>Among 43 recurrent HR-NMIBC patients with median age 67 years, 88.4% achieved 3-month complete response. Responders maintained a 24-month sustained response rate of 71.1% during median 28.4-month follow-up. The entire cohort demonstrated 36-month progression-free survival, overall survival, and cancer-specific survival rates of 82.8%, 85.0%, and 95.0% respectively. Subgroups with variant histology, BCG-unresponsive/intolerant disease, or multiple prior recurrences showed reduced responses. Treatment-related adverse events occurred in 90.7% of patients, with urinary frequency and hematuria being most common, which might stem from intravesical chemotherapy exposure. Grade 3 events affected 18.6% of patients, while immune-related adverse events led to discontinuation in 4.7%. No grade 4 or 5 toxicities were observed.</div></div><div><h3>Conclusion</h3><div>Tislelizumab plus intravesical chemotherapy achieves high response rates and durable survival benefits with manageable toxicity in recurrent HR-NMIBC, representing a promising non-BCG-dependent bladder-preserving strategy for surgically ineligible patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110988"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental dose-response effect of age on mortality in non-seminoma testis cancer patients","authors":"Reha-Baris Incesu M.D. ,&nbsp;Mattia Luca Piccinelli M.D. ,&nbsp;Simone Morra M.D. ,&nbsp;Lukas Scheipner M.D. ,&nbsp;Stefano Tappero M.D. ,&nbsp;Francesco Barletta M.D. ,&nbsp;Cristina Cano Garcia M.D. ,&nbsp;Zhe Tian M.Sc. ,&nbsp;Fred Saad M.D. ,&nbsp;Shahrokh F. Shariat M.D. ,&nbsp;Felix K.H. Chun M.D. ,&nbsp;Alberto Briganti M.D., Ph.D. ,&nbsp;Carlo Terrone M.D. ,&nbsp;Sascha Ahyai M.D. ,&nbsp;Nicola Longo M.D. ,&nbsp;Ottavio de Cobelli M.D. ,&nbsp;Derya Tilki M.D. ,&nbsp;Markus Graefen M.D. ,&nbsp;Pierre I. Karakiewicz M.D.","doi":"10.1016/j.urolonc.2026.110991","DOIUrl":"10.1016/j.urolonc.2026.110991","url":null,"abstract":"<div><h3>Background</h3><div>Age ≥ 40 predisposes to higher testis cancer-specific mortality (CSM) in non-seminoma. However, it is unknown, whether an incremental dose-response effect applies to subgroups of testis cancer patients (tertiles aged ≥ 40). We tested this hypothesis in contemporary non-seminoma patients.</div></div><div><h3>Methods</h3><div>The Surveillance, Epidemiology, and End Results (SEER) database (2004−2018) was used. Kaplan-Meier plots and multivariable Cox regression models tested the effect of age on CSM after stratification for stage (I vs. II vs. III).</div></div><div><h3>Results</h3><div>Of 13,679 non-seminoma patients, 11,034 (81%) were aged &lt; 40 vs. 2,645 (19%) were aged ≥ 40. Of patients aged ≥ 40, 943 were aged 40 to 44 (young age tertile) vs. 855 were aged 45 to 52 (intermediate age tertile) vs. 847 were aged ≥ 53 (old age tertile). In overall multivariable analyses relative to patients aged &lt; 40, young age tertile (Hazard ratio [HR] 1.4, <em>P</em> &lt; 0.01), intermediate age tertile (HR 1.9, <em>P</em> &lt; 0.001) and old age tertile (HR 3.6, <em>P</em> &lt; 0.001) were associated with higher CSM. In stage-specific multivariable analyses relative to patients aged &lt; 40, old age tertile predicted higher CSM in stage I (HR 4.7, <em>P</em> &lt; 0.001), stage II (HR 9.9, <em>P</em> &lt; 0.001) and stage III (HR 3.0, <em>P</em> &lt; 0.001). In stage III, intermediate age tertile (HR 1.9, <em>P</em> &lt; 0.001) and young age tertile (HR 1.5, <em>P</em> = 0.007) also predicted higher CSM.</div></div><div><h3>Conclusions</h3><div>We identified a dose-response effect of increasing age in non-seminoma patients aged ≥ 40, in the overall analysis as well as in stage-specific analyses.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110991"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LncRNA NPSR1-AS1 affects the malignant biological behavior of bladder cancer through miR-199a-3p and the clinical value of urine-derived lncRNA NPSR1-AS1","authors":"Weijing He M.D. ,&nbsp;Yong Wen M.D. ,&nbsp;Huiling Qin M.D.","doi":"10.1016/j.urolonc.2025.12.016","DOIUrl":"10.1016/j.urolonc.2025.12.016","url":null,"abstract":"<div><h3>Background</h3><div>The alteration of long noncoding RNA (lncRNA) expression is significantly associated with the occurrence and progression of various human tumors.</div></div><div><h3>Aim</h3><div>To explore the possible mechanism by which lncRNA NPSR1-AS1 affects bladder cancer, as well as its diagnostic and prognostic value.</div></div><div><h3>Material and methods</h3><div>The data related to bladder cancer were mined from the GEO database. RT-qPCR was used to determine the expression of lncRNA NPSR1-AS1 and miR-199a-3p in BCa tissues, cell lines and urine. Cell proliferation, migration and apoptosis and other cell functions were tested in UMUC3, T24 and cells. The interactions between molecules were studied using the luciferase reporter gene, RIP and Spearman correlation analysis. ROC, K-M and COX regression analyses were used to evaluate the clinical value of lncRNA NPSR1-AS1.</div></div><div><h3>Results</h3><div>The lncRNA NPSR1-AS1 was expressed at higher levels in BCa tissue cell lines and urine, while miR-199a-3p expression of was decreased. The lncRNA NPSR1-AS1 affected the malignant biological behavior of BCa by sponging miR-199a-3p. Cell function experiments demonstrated that silencing lncRNA NPSR1-AS1 could inhibit the proliferation, migration and apoptosis of UMUC3, T24 and RT4 cells, while the inhibition of miR-199a-3p reversed this effect. Clinically, lncRNA NPSR1-AS1 may serve as a diagnostic and prognostic marker for BCa.</div></div><div><h3>Conclusion</h3><div>LncRNA NPSR1-AS1 targets miR-199a-3p and affects the progression of BCa. Moreover, it can serve as a biomarker for BCa.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110980"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not all PI-RADS 3 lesions are the same: Higher rate of clinically significant prostate cancer among Black men on targeted biopsy in a diverse cohort","authors":"David G Hanelin ,&nbsp;Priya Dave M.D. ,&nbsp;Andrewe Baca M.D. ,&nbsp;Morgan Joseph ,&nbsp;Rutul Patel M.D. ,&nbsp;Alexander Sankin M.D. ,&nbsp;Ahmed Aboumohamed M.D. ,&nbsp;Stephen Reese M.D. ,&nbsp;Ilir Agalliu M.D., Sc.D. ,&nbsp;Kara Watts M.D.","doi":"10.1016/j.urolonc.2026.110995","DOIUrl":"10.1016/j.urolonc.2026.110995","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Radiogenomic studies suggest phenotypic differences in prostate cancer (PCa) appearance on MRI across racial groups. Counseling for PI-RADS 3 lesions is particularly challenging due to low positive predictive value and limited multi-ethnic data. We evaluated the association between PI-RADS score and PCa detection on MRI-targeted biopsy across a diverse patient population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of patients who underwent MRI-targeted fusion biopsy for PI-RADS 3 to 5 lesions between 2016 and 2024. Demographic and pathologic data were collected. Mixed-effects logistic regression assessed associations between race and PCa and csPCa, adjusting for clinical/radiographic features, stratified by PI-RADS score.</div></div><div><h3>Results</h3><div>646 patients with 1,146 lesions were analyzed (mean age 63.2 ± 7.6). The cohort was 48.1% Non-Hispanic Black (NHB), 32.5% Hispanic, and 19.3% Non-Hispanic White (NHW). PCa detection rates were 45.0% in NHB, 36.0% in Hispanic, and 35.8% in NHW. NHB had increased odds of overall and csPCa detection compared to NHW (Odds Ratio [OR] = 2.00; 95% Confidence Interval [95% CI] 0.96–4.18; <em>P</em> = 0.06, OR = 1.78, 95% CI 0.85–3.71; <em>P</em> = 0.12). On biopsy of PI-RADS 3 lesions, NHB men demonstrated nearly fivefold higher odds of csPCa detection compared to NHW and Hispanic cohorts (OR = 4.86; 95% CI 1.26–18.77; <em>P</em> = 0.02). No significant differences were observed between Hispanic and NHW men.</div></div><div><h3>Conclusions</h3><div>NHB had significantly higher odds of csPCa detection on targeted biopsy of PI-RADS 3 lesions. These findings support emerging data that phenotypic appearance of prostate cancer on MRI differs by race and may be relevant for risk stratification and management counseling of PI-RADS 3 lesions.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110995"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA in urothelial cancer as an intermediate disease state between localized and advanced stages: Moving from risk factors to micrometastatic disease in the perioperative setting","authors":"Sergio Bracarda M.D.,&nbsp;Giulia Mammone M.D.,&nbsp;Claudia Mosillo M.D.,&nbsp;Grazia Sirgiovanni M.D.,&nbsp;Annalisa Guida M.D.","doi":"10.1016/j.urolonc.2025.110986","DOIUrl":"10.1016/j.urolonc.2025.110986","url":null,"abstract":"<div><div>Urothelial carcinoma, especially muscle-invasive bladder cancer, presents a high risk of recurrence despite curative-intent surgery and perioperative therapies. A major clinical challenge remains the early identification of micrometastatic disease, undetectable with conventional imaging. Circulating tumor DNA (ctDNA), a minimally invasive biomarker, is emerging as a transformative tool for detecting minimal residual disease, allowing for earlier intervention and more tailored and efficacious treatment strategies. This review explores the evolving role of ctDNA in urothelial carcinoma, particularly in the perioperative setting. The negative adjuvant IMvigor010 trial established ctDNA as a prognostic and potentially predictive marker, demonstrating that ctDNA-positive patients postcystectomy were at higher risk of relapse but could benefit from adjuvant immunotherapy. Building on this, IMvigor011 prospectively validated a ctDNA-guided immunotherapy approach, showing that ctDNA clearance correlates with improved disease-free survival. We discuss ctDNA potential to redefine disease staging, introducing an “intermediate” category (M0, ctDNA-positive) between localized and overtly metastatic disease. ctDNA also offers value in surveillance, treatment de-escalation, and monitoring therapeutic response. Advances in tumor-informed assays have enhanced the sensitivity of ctDNA detection, though standardization and accessibility remain key challenges. In summary, ctDNA represents a paradigm shift in urothelial carcinoma management, enabling precision oncology through real-time disease monitoring and personalized treatments. Its integration into clinical practice may improve outcomes by addressing micrometastatic disease before clinical relapse or progression, transforming the way we stratify and treat patients across the urothelial carcinoma continuum.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110986"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal adjuvant intravesical therapy for intermediate risk non-muscle invasive bladder cancer; oncological and patient-reported outcomes of randomized controlled trial","authors":"Amr A. Elsawy M.D.,&nbsp;Mahmoud Laymon M.D.,&nbsp;Osama Ezzat M.D.,&nbsp;Islam Mansour M.D.,&nbsp;Abdullah A. Sobh M.D.,&nbsp;Ehab A. Nour M.D.,&nbsp;Ahmed Mosbah M.D.","doi":"10.1016/j.urolonc.2026.111006","DOIUrl":"10.1016/j.urolonc.2026.111006","url":null,"abstract":"<div><h3>Background</h3><div>Adjuvant Intravesical BCG and chemotherapy are utilized viables options for intermediate-risk (IR) NMIBC. We are lacking well-designed evidence for superiority of any in terms of effectiveness, toxicity, and patient tolerability.</div></div><div><h3>Objectives</h3><div>We compared the oncological outcomes, treatment-related adverse events (AEs) and Health-related quality of life (HRQoL) in IR NMIBC patients who received intravesical BCG vs. intravesical Epirubicin.</div></div><div><h3>Materials and methods</h3><div>After institutional review board (IRB) approval, 134 patients were randomly allocated into two groups; adjuvant intravesical BCG and intravesical Epirubicin. Patients were followed every 3 to 6 months by cystourethroscopy and urine cytology. The primary end points were recurrence, progression, and disease-free survivals. The secondary end points comprised treatment-related AEs and quality of life using HRQoL-EORTC QLQ-30 questionnaire.</div></div><div><h3>Results</h3><div>Of the 134 patients, 122 were followed for a mean of 19 months and included in the final analysis. There were no statistically significant differences between the two groups in terms of baseline demographic/tumor criteria. The tumor recurrence and progression rates were comparable between BCG vs. Epirubicin groups, (19.4% vs. 28.5%), (6.5% vs. 5%), respectively. Mean time to recurrence and RFS were significantly prolonged in BCG group (18 vs. 16.7 months, Log rank <em>P</em> = 0.02) While time to progression and PFS were statically comparable between the two groups (18.5 vs. 18.3 months, Log rank <em>P</em> = 0.76). Local treatment-related AEs as dysuria/urgency/frequency were significantly more reported in BCG group (19.5% vs. 10%, <em>P</em> = 0.03). BCG group experienced significantly worse HRQoL in terms of urinary symptoms and treatment-related future worries domains (<em>P</em> = 0.008, 0.001, respectively).</div></div><div><h3>Conclusions</h3><div>In patients with IR NMIBC, adjuvant intravesical therapy with BCG and Epirubicin are equivalent in terms of recurrence and progression rates. Nevertheless, RFS was significantly prolonged in patient receiving intravesical BCG. On the contrary, patients treated with BCG experienced significantly more local bladder symptoms and worse HRQoL in terms of bothering urinary symptoms and negative treatment-related future worries.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 111006"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbial profiling of urothelial carcinoma and benign bladder tissue from formalin-fixed specimens","authors":"Matt Pearson MD ,&nbsp;Phillip A. Engen MS ,&nbsp;Stefan J. Green PhD ,&nbsp;Jake Emerson MD ,&nbsp;Ankur Naqib PhD ,&nbsp;Paolo Gattuso MD ,&nbsp;Ali Keshavarzian MD ,&nbsp;Christopher Coogan MD","doi":"10.1016/j.urolonc.2026.110997","DOIUrl":"10.1016/j.urolonc.2026.110997","url":null,"abstract":"<div><h3>Purpose</h3><div>Host-associated microbiota can influence host immunity and tumor responses. Emerging evidence suggests the bladder microbiome contributes to urothelial cell carcinoma (UCC), though most data come from urine samples. Urinary microbiomes are different in UCC compared to inflamed bladder, though their impact on host immune responses is understudied. Similarly, the effect of <em>Bacillus</em> Calmette–Guérin (BCG) treatment on bladder microbiome remains unexplored.</div></div><div><h3>Materials and Methods</h3><div>Formalin-fixed paraffin-embedded (FFPE) transurethral resection of bladder tumor (TURBT) specimens from UCC tumor stages (T1 = 42), (T2 = 5), and 16 benign pathologies were examined. Six patients who underwent BCG vaccine with post-treatment TURBT specimens were examined. Microbial communities were characterized using RNA extraction, reverse transcription, and 16S rRNA amplicon sequencing.</div></div><div><h3>Results</h3><div>UCC patients exhibited greater microbial diversity and distinct bladder microbiome compositions compared to those with benign pathology. Several genera in the bladder including <em>Streptococcus, Staphylococcus, Actinomyces</em>, and <em>Cutibacterium</em> were more abundant in the benign group. Conversely, T1-UCC patients showed higher relative abundances of putative proinflammatory genera including <em>Escherichia-Shigella</em> and unclassified Yersiniaceae, plus commonly reported skin-associated dysbiotic genera <em>Enhydrobacter</em> and <em>Micrococcus</em>. Five of 6 BCG-treated patients showed marked reduction in microbial diversity along with significant alteration in their microbiome composition, including decreased relative abundance of bacteria from genera <em>Streptococcus</em> and <em>Rothia</em>.</div></div><div><h3>Conclusions</h3><div>This proof-of-concept study suggests that: (1) microbiome sequencing from FFPE TURBT specimens can be used for microbiota assessment and can effectively distinguish UCC from benign pathology. (2) bladder microbiomes are heavily depleted following BCG treatment, indicating therapy-induced microbiome alterations.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110997"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient awareness and perspectives regarding the value of focal therapy for localized prostate cancer: A cross-sectional study","authors":"Abdul-Qahar K. Yasinzai M.D. ,&nbsp;Jordan Smith M.D. ,&nbsp;Amica Lertkitcharoenpo B.S. ,&nbsp;Rafael A. Bourricaudy B.S. ,&nbsp;Jane J. Chang M.S. ,&nbsp;Thomas F. Stringer M.D., F.A.C.S. ,&nbsp;John Michael DiBianco M.D. ,&nbsp;Jason P. Joseph M.D. ,&nbsp;Padraic O’Malley M.D., F.R.C.S.C. ,&nbsp;Paul L. Crispen M.D. ,&nbsp;Li-Ming Su M.D., F.R.C.S. ,&nbsp;Tarik Benidir M.D., F.R.C.S.C.","doi":"10.1016/j.urolonc.2026.110993","DOIUrl":"10.1016/j.urolonc.2026.110993","url":null,"abstract":"<div><h3>Background</h3><div>With the expanding therapeutic options for localized prostate cancer (PCa), little is known regarding patient values and perspectives that influence the selection process for focal therapy (FT) vs. conventional treatments. This study explores the socioeconomic and demographic factors that influence patients' decisions for FT.</div></div><div><h3>Methods</h3><div>This was a single-center cross-sectional study using a patient-centered survey of men with concerns about or a diagnosis of localized prostate cancer who were potential candidates for focal therapy. Information on patient demographics and clinical status was collected along with hypothetical scenarios to study the preferences of patients. Descriptives and univariate tests of associations were utilized for analysis.</div></div><div><h3>Results</h3><div>In total, 158 patients were enrolled; only 41.1% of patients had prior knowledge of FT. Among those with a diagnosis of PCa and endorsing prior FT knowledge, 44.3% did not understand its efficacy, while 27.9% did not know if FT has any potential side effects. Education and income significantly influenced FT knowledge. Specifically, 52.4% of patients with advanced education were familiar with FT compared to 20% of those with only a high school education (<em>P</em> &lt; 0.01). Patients with income of &gt;$75,000 were more likely to be aware of FT (60.7%, <em>P</em> = 0.010). Interestingly, neither disease stability nor treatment status influenced therapy preferences. Sexually active patients were more likely to be aware of FT as an option.</div></div><div><h3>Conclusions</h3><div>A considerable proportion of PCa patients, specifically those in lower socioeconomic groups, remain unaware of FT’s existence and its potential role in well-selected PCa management. Educated and higher-income patients had comparatively better knowledge about FT and also leaned towards functional outcomes. As FT demand continues to expand, addressing knowledge gaps is crucial to ensure informed and equitable healthcare delivery.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110993"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}